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General NPI Number Information
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NPI Number | 1003479395
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Entity Type | Organization
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Legal Business Name | CHESCO SERVICES
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 1224 EAST BLVD
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City | CHESTERFIELD
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State | SC
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Zip | 29709-5148
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Country | US
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Telephone | 843-623-9016
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Fax | 843-623-5406
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Provider Business Mailing Address
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Address Line | PO BOX 151
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City | CHESTERFIELD
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State | SC
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Zip | 29709-0151
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Country | US
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Telephone | 843-623-9016
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Fax | 843-623-5406
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | JEAN R WATSON
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Credential |
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Telephone | 843-623-5436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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